jamie goode's wine blog: When the drugs don't work

Monday, January 18, 2010

When the drugs don't work

I've just taken my medication, with a glass of wine. I'm reminded of a comment I heard by a very senior pharmaceutical chief at a small meeting I was involved with in my previous life - held in Basle, Switzerland, with luminaries such as Peter Goodfellow and Craig Venter in attendance. It was looking at genomics. Allen Roses from GSK suggested that the vast majority of drugs only work in perhaps 30-50% of people (see hBBC report here).

Why? It's because of individual differences. We're all wired slightly different. While Roses may have been exaggerating a little (it would be fairer to say that there are a number of people in whom drugs have no effect, but that the effect of most drugs varies quite a bit among others, making it hard to get doses right), he does have a point.

I'm fascinated by individual differences, especially where they relate to the perception of wine. I've mentioned before that a winewriter I greatly respect loves Springfield's Life From Stone Sauvignon Blanc; I hate it - I think the wall of pure, unripe, methoxypyrazine character this wine presents to me is verging on a fault.

But Roses' point is that if we can get a handle on peoples' genetic make up, for example by cheap SNP arrays, we can prescribe drugs much more accurately. Personalized medicine. We can also rescue useful drugs that have failed clinical trials because of their adverse effects in small groups.


At 3:16 PM, Blogger David Bennett- Optometrist and Contact Lens Practitioner said...

I think Big Pharma should read Ben Goldacre's blog. They would get a better understanding of stats as I'm sure you would agree!

Its the old n=1 that is used so ubiquitously to sell product - any product, wine included, that makes for "interesting" (and false) stats.
Now I'm no statistition (dull job if you ask me!) but Ben seems to make it rather interesting to the average Joe like me. A bit like Feinmann did with Physics, if you get my drift.

At 8:23 PM, Anonymous Anonymous said...

lart mikid

At 9:09 PM, Anonymous Anonymous said...

Couldn't agree more on wine sensitivities. No disrespect intended, but when I've tasted wines you've tasted, I disagree with you at least half the time. Twenty years ago I noticed I disagreed with Parker about 90% of the time. That's why I don't trust community tasting groups (eg CellarTracker), and I do trust the buyer at one merchant, with whom I've tasted on numerous occasions. If they're selling it, I'll probably like it.

At 10:19 PM, Blogger Jamie said...

thanks for your comments, and for your honesty, anon - I'd find it bizarre if everyone agreed with my preferences

At 12:32 PM, Anonymous David Strange said...

The low hit-rate of medication is particularly pronounced when it comes to psychiatric drugs. As I have paranoid schizophrenia I've tried one hell of a lot of them and my experiences with these drugs always brought to mind something a professor of pharmacology told me when I was an academic: "Psychiatric pharmacology is an emerging science, which is what we call 'bollocks' here at Oxford." I useful construction which I was happy to recycle when talking about less 'hard' sciences than I thought I was engaged in. Genetically targeted drugs and gene-therapy are clearly the way forward in the future. Amazing things will happen.

At 12:35 PM, Anonymous David Strange said...

Oh and I've tried Springfield's Life From Stone Sauvignon Blanc once and that was enough. I thought it was actively nasty. But heaven forbid that everyone should agree with me/us, variety is the spice of life.

At 8:32 PM, Anonymous Steve said...

The placebo effect is often estimated at 35% but varies wildly. A drug is consider successful if it beats the placebo in trials.

In wine tasting, it seems to me that alpha tasters can be seen as the equivalent as the placebo effect. If he alpha taster is convinced that there is raspberry and a hollow mid-palate, several heads will nod in agreement.

Anyway, I hope you feel better soon, Jamie.


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